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J Jørgensen

Publications and source records attributed to J Jørgensen.

At least 19 recordsLinked to original sources
PubMed2002

[Bioptic. A refractive surgery procedure for correction of high and extreme myopia].

BACKGROUND: The complete correction of highly or extremely myopic eyes to emmetropia can only be achieved by very few procedures: The combination of implanting phacic intraocular lenses and the use of LASIK (laser in-situ keratomileusis) - Bioptic - makes it possible to achieve this goal to a great extent. PATIENTS AND METHODS: The Bioptic procedure was carried out on 17 eyes of 10 patients. Two weeks after corneal dissection with the Hansatom,an implantable phacic lens (STAAR) was introduced into the posterior chamber and 4 weeks later the residual myopia was treated with LASIK combined with the correction of astigmatic errors. The follow-up time was 10.2 (6.7) months. RESULTS: Preoperative average values of the manifest refraction were -16.22 sph (3.86) with 1.40 cyl (1.30) which changed to -3.85 sph (2.73) with -1.50 cyl (0.87) after implantation of an ICL trade mark into the posterior chamber. Visual acuity increased from uncorrected hand motion to 0.13 (0.10) and corrected from 0.53 (0.19) to 0.63 (0.19). The refraction of implanted ICLs trade mark was 14.6 dpt (1.1). Following the LASIK procedure the uncorrected visual acuity improved to 0.68 (0.16) and fully corrected to 0.79 (0.20). The final refraction measured +0.16 sph (0.67) with -0.48 cyl (0.25). The keratectomy depth was 80.63 -m (26.9) and the optical zone showed a horizontal distance of 6.28 mm (0.39). CONCLUSION: Bioptic is able to correct highly and extremely myopic eyes with the combination of phacic lenses and subsequent LASIK. A concomitant astigmatism can be corrected up to 2.5 dpt simultaneously. With the combination of both procedures,the optical zone can be enlarged. Keeping in mind that phacic lenses reveal a constant refraction after a few days and also that LASIK is refractively safe in low myopia of -4 dpt to -5 dpt, it can be expected that the refractive deviation following the Bioptic procedure is low.

Astigmatism↗
PubMed2002

Section 1B: Rh flow cytometry. Coordinator's report. Rhesus index and antigen density: an analysis of the reproducibility of flow cytometric determination.

Fifty-seven IgG monoclonal anti-D antibodies were evaluated in the Rh flow cytometry section, in which 12 laboratories participated. Staining protocols and a fluorescein (FITC)-conjugated Fab fragment goat anti-human IgG (H + L) as a secondary antibody were recommended but not mandatory. A CcDEe red blood cell (RBC) sample that was shown to be homozygous for RHD by molecular methods was supplied and used as internal 'standard RBC' throughout all experiments. An RBC panel comprising two partial D and four weak D types was supplied as well. The use of standard RBC reduced the variability of the data among the laboratories and allowed the conversion of fluorescence data into epitope densities, which were compounded in an antigen density (antigen D per RBC). The highest antigen density was determined for DVI type III, followed by DVII and weak D type 3; the lowest antigen density were determined for weak D type 1 and type 2. Nine of the 12 participating laboratories discriminated three groups of aberrant RhD that had similar Rhesus indices (RI): D category VI with RI = 0; weak D type 2 and type 3 with an high RI; and D category VII and weak D type 1 with an intermediate RI. The antigen densities and the Rhesus indices obtained correlated well among the laboratories of this Workshop section despite different staining protocols, secondary antibodies and instrumentation.

Algorithms↗
PubMed2001

Hydrogen sulfide and colonic epithelial metabolism: implications for ulcerative colitis.

Hydrogen sulfide (HS-) impairs the oxidation of butyrate in colonocytes and is found in excess in feces of patients with ulcerative colitis. The possible pathogenic role of HS- in ulcerative colitis was further investigated. To investigate the metabolic effect of free and bound fecal HS-, isolated rat colonocytes were incubated in the presence of butyrate without and with the addition of (1) HS- in water, (2) sterile filtrates of fecal homogenates supplemented and incubated with HS- and known sources of fecal HS- production, and (3) HS- incubated with fecal agents known to bind HS-. Oxidation rates were obtained by quantifying the production of CO2. Total and free HS-, as well as the fecal ability to bind HS-, were determined in health and ulcerative colitis. Compared to the production of CO2 by colonocytes incubated with 2 mmol/liter of butyrate, the further addition of 1.25 and 2.5 mmol/liter of HS- in water reduced the production of CO2 by 57.6+/-10.0 and 98.9+/-1.4%, respectively. However, when adding fecal filtrate of homogenate supplemented with HS- corresponding to 1.25 and 2.5 mmol/liter of HS- in water, the reduction of CO2 production was only 30.7+/-12.0 and 53.2+/-14.0%, respectively. Neither the fecal level of total or free HS- nor the remarkable fecal ability to bind HS- differed in health or quiescent and active ulcerative colitis. Bound HS- had no or little effect on CO2 production. Addition of fecal filtrate of nonsupplemented homogenate to colonocytes significantly reduced the oxidation of butyrate to CO2 about 25%, which could not be ascribed to fecal HS-. In conclusion, fecal HS- has little effect on butyrate oxidation in colonocytes and does not seem to play a pathogenic role for UC by impairing colonic epithelial metabolism. Other fecal agents seem to be more potent metabolic inhibitors than fecal HS-. The role of colonic contents in the pathogenesis of ulcerative colitis remains circumstantial.

Adult↗
PubMed2001

Substrate utilization by intestinal mucosal tissue strips from patients with inflammatory bowel disease.

A primary metabolic disorder may be present in the colonic mucosa of patients with ulcerative colitis. Preserving the epithelium in situ, we evaluated the metabolism of the colonic mucosa of control patients and patients with ulcerative colitis and Crohn's disease. Colonic mucosal strips (approximately 500 mg) were incubated with partially 14C-labeled acetate (C2), butyrate (C4), hexanoate (C6), octanoate (C8), and glucose, and the production of CO2 and ketone bodies was quantitated. Metabolism by small intestinal mucosal strips was also evaluated. Compared with controls, no decrease in either CO2 or ketone body production by colonic strips from patients with either ulcerative colitis or Crohn's disease was observed for any substrate. The CO2 production from each of the C2-C8 fatty acids was the same for colonic and small intestinal strips, whereas CO2 production from glucose was higher in small intestinal strips than in colonic strips. The production of ketone bodies was low in small intestinal strips. A primary metabolic disorder in the colonic mucosa of patients with inflammatory bowel disease was not found.

Acetates↗
PubMed2001

Incidence and late prognosis of cushing's syndrome: a population-based study.

The main purpose was to assess the incidence and late outcome of Cushing's syndrome, particularly in Cushing's disease. Information for all patients diagnosed with Cushing's syndrome during an 11-yr period in Denmark was retrieved. The incidence was 1.2-1.7/million.yr (Cushing's disease), 0.6/million.yr (adrenal adenoma) and 0.2/million.yr (adrenal carcinoma). Other types of Cushing's syndrome were rare. In 139 patients with nonmalignant disease, 11.1% had died during follow-up (median, 8.1 yr; range, 3.1-14.0), yielding a standard mortality ratio (SMR) of 3.68 [95% confidence interval (CI), 2.34-5.33]. The SMR was partly attributable to an increased mortality within the first year after diagnosis. Eight patients died before treatment could be undertaken. The prognosis in patients with malignant disease was very poor. Patients in whom more than 5 yr had elapsed since initial surgery were studied separately, including a questionnaire on their perceived quality of health. In 45 patients with Cushing's disease who had been cured through transsphenoidal neurosurgery, only 1 had died (SMR, 0.31; CI, 0.01-1.72) compared with 6 of 20 patients with persistent hypercortisolism after initial neurosurgery (SMR, 5.06; CI, 1.86-11.0). In patients with adrenal adenoma, SMR was 3.95 (CI, 0.81-11.5). The perceived quality of health was significantly impaired only in patients with Cushing's disease and appeared independent of disease control or presence of hypopituitarism. It is concluded that 1) Cushing's syndrome is rare and is associated with increased mortality, in patients with no concurrent malignancy also; 2) the excess mortality was mainly observed during the first year of disease; and 3) the impaired quality of health in long-term survivors of Cushing's disease is not fully explained.

Adolescent↗
PubMed2001

Is an increased intestinal permeability a valid predictor of relapse in Crohn disease?

BACKGROUND: An increased intestinal permeability (IP) may be a pathogenetic factor in Crohn disease (CD). Increases in IP could be an indicator of subclinical disease and precede clinical relapses. We examined whether an increased IP is a valid predictor of relapse in CD. METHODS: 27 patients with CD in remission (CDAI <150) and 22 healthy controls ingested 3.7 MBq of 51Cr-EDTA, 20 kBq of 14C-mannitol and 5 g of unlabelled mannitol in 100 ml of distilled water. The percent urine excretion (24 h) of labelled markers was determined. Patients were followed for 1 year or until relapse, defined as CDAI > 150 and > 50 from baseline. RESULTS: Median (25th-75th percentiles). The excretion of 51Cr-EDTA was 1.55% (1.13%-2.53%) for patients and 1.20% (1.11%-1.44%) for controls (P = 0.04). Three of 9 patients with a raised, and 6 of 18 patients with a normal, 51Cr-EDTA excretion relapsed (P = 1.00; Fisher's exact test). Thus, the specificity and sensitivity of the 51Cr-EDTA test as a predictor of relapse was 67% and 33%, respectively. The 51Cr-EDTA/14C-mannitol index was 0.060 (0.037-0.093) for patients and 0.045 (0.038-0.054) for controls (P = 0.06). Four of 12 patients with a raised, and 5 of 15 patients with a normal, index relapsed (P = 1.00; Fisher's exact test). Thus, the specificity and sensitivity of the index test as a predictor of relapse was 56% and 44%, respectively. For controls and patients in remission, who were tested twice, variability of and fluctuations in both the 51Cr-EDTA excretion and the index were greatest for patients. CONCLUSIONS: This study supports previous findings of an increased IP in patients with CD. Although fluctuations in the permeation of markers were pronounced in CD, neither the excretion of 51Cr-EDTA nor the 51Cr-EDTA/14C-mannitol index test were valid predictors of relapse in CD.

Adult↗
PubMed2000

[Medicine and literature--interpretation and discussion of literary texts in medical education].

BACKGROUND: In medical education, using literary texts as a starting point for discussion and reflection, is now quite common. Lectures and seminars in literature and medicine have been given at the University of Oslo since 1996. We describe our pedagogical approach as a "thematic interpretation and discussion of literary texts", theoretically grounded in reader-oriented criticism and problem-based learning (PBL). This article describes the kind of learning taking place during analysis and discussion of literary texts among medical students. MATERIAL AND METHODS: We evaluated a series of four elective seminars for first and second year students in the autumn 1998. We used qualitative approaches based on analysis of material from observations during seminars, reflections written by participants, and notes from a group interview at the end of the seminars. RESULTS: Analysis and discussion of literary texts may give medical students: A better understanding of communicative aspects in the doctor-patient-relationship. Experience with interpretation of narratives and insight into how differently we may interpret a story. Awareness of aspects and dilemmas related to being a doctor. Understanding of how people may experience illness and health. INTERPRETATION: Lectures and seminars on literary texts might be an important supplement to other practical or theoretical teaching for medical students.

Communication↗
PubMed2000

Utilization of short-chain fatty acids by colonic mucosal tissue strips. A new method of assessing colonic mucosal metabolism.

BACKGROUND: Previous metabolic studies of the colonic mucosa have been done using isolated cells or small biopsy specimens. METHODS: A new method for assessing the utilization of short-chain fatty acids in human colonic mucosal tissue strips considerably larger than routine samples was evaluated and compared with the method of isolated colonocytes. Human colonic mucosal strips and isolated human and rat colonocytes were incubated with acetate (C2), butyrate (C4), and hexanoate (C6), and oxidation rates obtained by quantifying the production of CO2. RESULTS: The wet weight of strips was highly correlated with the production of CO2, and intersample coefficient of variance was <10%. The production of CO2 from the oxidation of C2, C4, and C6 was in the order of C2 > C4 > C6 for both strips and isolated human and rat colonocytes. The production of adenosine triphosphate (ATP) in strips and isolated human and rat colonocytes was in the order of C2 < or = C4 < or = C6. The Km value for the oxidation of butyrate to CO2 in strips (1.8 mmol/l) was several times higher than previously reported for isolated human and rat colonocytes (0.1-0.3 mmol/l). CONCLUSIONS: This new method is highly reproducible and able to assess the metabolic activity of the colonic mucosa. The high Km value of butyrate oxidation in mucosal strips seems to reflect the in vivo Km value of colonocytes and shows the importance of a preserved anatomic structure in metabolic studies of the colonic epithelium. The low Km value for isolated colonocytes probably reflects the intracellular ability to oxidize butyrate. We propose that both isolated colonocytes and mucosal strips be used in studies of colonic mucosal metabolism. This method is relevant in disease states of the colon in which a disagreement prevails as to the ability to oxidize butyrate by colonocytes, such as in ulcerative colitis.

Acetates↗
PubMed1999

Interrater reliability of a Danish version of the Morgan Russell scale for assessment of anorexia nervosa.

OBJECTIVE: To study the interrater reliability of a Danish version of the Morgan Russell scale for assessment of patients with anorexia nervosa, and subsequently to clarify the existing rating instructions. METHOD: Ten patients undergoing treatment for anorexia nervosa at a regional center participated and had their interview videotaped. Two interviews were reserved for a training phase only. The group of raters comprised eight clinicians, and measures of interrater reliability were computed using intraclass correlation coefficient (ICC). RESULTS: The ICC for the total score was good (0.79), while reliability for the single items varied from poor to excellent (0.14-0.99). Internal consistency as expressed by Cronbach's coefficient alpha was acceptable (0.74). DISCUSSION: The Morgan Russell scale stands out as an easily applied and reliable measure of severity of anorexia nervosa, though the rating instructions need clarification in some items.

Adolescent↗
PubMed1999

The Danish National Hospital Register. A valuable source of data for modern health sciences.

The Danish National Hospital Register (LPR) has collected nationwide data on all somatic hospital admissions since 1977, and since 1995 data on outpatients and emergency patients have been included as well. Numerous research projects have been undertaken in the national Danish context as well as in collaboration with international teams, and the LPR is truly a valuable source of data for health sciences, especially in epidemiology, health services research and clinical research. Nearly complete registration of somatic hospital events in Denmark is combined with ideal conditions for longterm follow-up due to the existence of a national system of unique person identification in a population of relative demographic stability. Examples of studies are provided for illustration within three main areas: I: Using LPR for surveillance of the occurrence of diseases and of surgical procedures, II: Using the Register as a sampling frame for longitudinal population based and clinical research, and III: Using the Register as a data source for monitoring outcomes. Data available from the Register as well as studies of the validity of the data are mentioned, and it is described how researchers may get access to the Register. The Danish National Hospital Register is well suited to contribute to international comparative studies with relevance for evidence-based medicine.

Denmark↗
PubMed1999

Reference values and biological variation for tumor marker CA 19-9 in serum for different Lewis and secretor genotypes and evaluation of secretor and Lewis genotyping in a Caucasian population.

The concentration of the tumor marker CA 19-9 is influenced by the patient's secretor status and Lewis genotype. The aim of this study was to establish novel reference intervals for CA 19-9 in serum based on secretor and Lewis genotypes, to investigate the biological variation of CA 19-9, and to evaluate the utility of Lewis and secretor genotyping on a group of individuals with serologically defined Lewis phenotypes. CA 19-9 was measured in serum of 500 healthy individuals. Secretor and Lewis genotypes were determined by sequencing and PCR-cleavage methods. Significant differences were found between subgroups with different Lewis and secretor genotypes. Genotype-based reference intervals for CA 19-9 are presented. The upper reference limit for all individuals was 28.7 kilounits/L; for secretors and nonsecretors, the upper reference limits were 12.4 and 61.2 kilounits/L, respectively. The analytical imprecision (CVA) was 9.8%, the within-subject variability (CVI) was 15.8%, and the between-subject variability (CVG) was 102.2%. Good agreement was found between Lewis and secretor genotyping and conventional blood grouping. Genotype-based reference intervals may be a way to increase the clinical utility of CA 19-9. On the basis of the calculation of a critical difference for sequential values (significant at P </=0.05) of 51.5%, a 40-50% change in marker concentration is suggested as the limit for significant change when the marker is used for follow up. PCR-based genotyping is a reliable method for secretor and Lewis histo-blood grouping.

Adult↗
PubMed1998

Comparison of diarrhea induced by ingestion of fructooligosaccharide Idolax and disaccharide lactulose: role of osmolarity versus fermentation of malabsorbed carbohydrate.

Whether carbohydrate malabsorption causes diarrhea probably depends on the balance between the osmotic force of the carbohydrate and the compensatory capacity of the colon to dispose of the carbohydrate by bacterial fermentation. The present study evaluated the specific role of the osmolarity by comparing the severity of diarrhea after ingestion of two nonabsorbable carbohydrates, the fructooligosaccharide Idolax and the disaccharide lactulose. Both carbohydrates are readily fermented by the colonic flora but differ in osmolarity, the osmotic force being twice as high for lactulose as for Idolax. Twelve subjects were given increasing doses (0, 20, 40, 80, 160 g/d) of Idolax and lactulose in a crossover design. Every dose level was administered for three days with intervals of one week. Stools were collected on the third day to determine 24-hr volume, concentrations of short-chain fatty acids, L- and D-lactate, residues of Idolax or lactulose, sodium, potassium, pH, osmolarity, and in vitro productions of organic acids. Measured by short-chain fatty acid and lactate formation in a fecal incubation system, the fermentation of Idolax and lactulose was identical and very rapid compared with a range of reference carbohydrates. A laxative effect of both Idolax and lactulose was demonstrated. The increment in fecal volume as a function of the dose administered was twice as high for lactulose (slope of the regression line = 7.3, r = 0.64, P< 10(-5)) as for Idolax (slope = 3.7, r = 0.51, P<10(-3)), i.e., isosmolar doses of lactulose and Idolax had the same effect on fecal volume. The variation in fecal volume was substantial (lactulose 80 g/day: 110-1360 g/day; Idolax 160 g/day: 130-1440 g/day). High responders had earlier and larger fecal excretions of the saccharide compared with low-responders. Fecal volume in carbohydrate-induced diarrhea is proportional to the osmotic force of the malabsorbed saccharide, even though all or the majority of the saccharide is degraded by colonic bacteria. The capacity to modify the diarrhea varies considerably from person to person and is associated with colonic saccharide disposal, whereas the variation in response to isosmolar amounts of different saccharides is small within the same individual.

Adult↗
PubMed1998

Human rectal absorption of short- and medium-chain C2-C10 fatty acids.

BACKGROUND: Current knowledge on the colonorectal absorption of medium-chain fatty acids is limited. The purpose of the present study was to evaluate and compare the human rectal absorption of short- and medium-chain C2-C10 fatty acids in healthy volunteers. METHODS: Dialysis bags containing 20 mmol x l(-1) of the fatty acids acetate, butyrate, hexanoate, octanoate, or decanoate in a phosphate-buffered (pH neutral) isoosmotic electrolyte solution were placed in the rectum for 30 min in 14 healthy volunteers. Absorption rates were calculated for all fatty acids, sodium, potassium, and water. RESULTS: Absorption rates of the fatty acids acetate, butyrate, hexanoate, octanoate or decanoate were the same (1.9 +/- 0.1 = 2.5 +/- 0.2 = 1.7 +/- 0.2 = 1.9 +/- 0.2 = 2.2 +/- 0.1 micromol x cm(-2) x h(-1) (mean +/- standard error of the mean), respectively; P = 0.24). CONCLUSIONS: Medium-chain fatty acids were absorbed in the human rectum at a rate similar to that for short-chain fatty acids. If results can be applied to the human colon, colonic absorption of medium-chain fatty acids could possibly become an important secondary site of absorption in abnormal intestinal conditions such as massive small-intestinal resection or malabsorption syndromes.

Administration, Rectal↗
PubMed1997

[Resectability of papillary and pancreatic cancer assessed by ultrasonography and computer tomography].

A retrospective study of 65 patients with postoperatively verified pancreatic or peripancreatic cancer was conducted. Before surgery all patients had ultrasonography (US) performed, and 46 patients had computed tomography (CT) performed as well. After operation description of pre-operative radiological findings has been compared to description of operative and pathological findings. Three of the 65 patients were excluded either because of lacking radiological descriptions (two patients) or uncertain operative findings (one patient). When both investigations were performed, they were carried out independently by two skilled radiologists without knowledge of the result of the other investigations. The following criteria were used for non-resectability encasement of splanchnic vessels, liver metastases, peritoneal thickening with ascites, and glandular enlargement. As assessed by US, 15 of 16 (94%) were truly predicted to be non-resectable, whereas only 21 of 38 (55%) were truly predicted resectable. CT was performed in 46 patients of which 19 of 21 (90%) were truly predicted non-resectable, and 17 of 21 (81%) were truly predicted resectable. It was not possible to perform a conclusive radiological investigation in eight of 62 (13%) cases by US, and four of 46 (9%) cases by CT. One patient was falsely predicted non-resectable by US and an additional one by CT. Both were falsely predicted non-resectable on suspicion of vessel involvement. Overall, invasion of vessels was the most common cause for non-resectability, at the same time this was the index of non-resectability that was most often not detected pre-operatively. US is reliable when predicting non-resectability. When resectable tumour is detected by US, supplementary investigations such as CT should be applied, and when necessary endoscopic procedures or laparoscopy as well. Hereby unnecessary laparotomies may be avoided. Care should be taken when suspecting papillary tumour; only 66% of these were detected by either of the two methods.

Endosonography↗